Posttreatment after Lenvatinib in Patients with Advanced Hepatocellular Carcinoma
Background: There is no standard posttreatment for patients with advanced hepatocellular carcinoma (HCC) in whom lenvatinib therapy has failed. This study aimed to investigate rates of migration to posttreatment after lenvatinib and to explore candidates for second-line agents in the patients with f...
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| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2021-04-01
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| Series: | Liver Cancer |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/515552 |
| _version_ | 1819015446174629888 |
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| author | Keisuke Koroki Naoya Kanogawa Susumu Maruta Sadahisa Ogasawara Yotaro Iino Masamichi Obu Tomomi Okubo Norio Itokawa Takahiro Maeda Masanori Inoue Yuki Haga Atsuyoshi Seki Shinichiro Okabe Yoshihiro Koma Ryosaku Azemoto Masanori Atsukawa Ei Itobayashi Kenji Ito Nobuyuki Sugiura Hideaki Mizumoto Hidemi Unozawa Terunao Iwanaga Takafumi Sakuma Naoto Fujita Hiroaki Kanzaki Kazufumi Kobayashi Soichiro Kiyono Masato Nakamura Tomoko Saito Takayuki Kondo Eiichiro Suzuki Yoshihiko Ooka Shingo Nakamoto Akinobu Tawada Tetsuhiro Chiba Makoto Arai Tatsuo Kanda Hitoshi Maruyama Jun Kato Naoya Kato |
| author_facet | Keisuke Koroki Naoya Kanogawa Susumu Maruta Sadahisa Ogasawara Yotaro Iino Masamichi Obu Tomomi Okubo Norio Itokawa Takahiro Maeda Masanori Inoue Yuki Haga Atsuyoshi Seki Shinichiro Okabe Yoshihiro Koma Ryosaku Azemoto Masanori Atsukawa Ei Itobayashi Kenji Ito Nobuyuki Sugiura Hideaki Mizumoto Hidemi Unozawa Terunao Iwanaga Takafumi Sakuma Naoto Fujita Hiroaki Kanzaki Kazufumi Kobayashi Soichiro Kiyono Masato Nakamura Tomoko Saito Takayuki Kondo Eiichiro Suzuki Yoshihiko Ooka Shingo Nakamoto Akinobu Tawada Tetsuhiro Chiba Makoto Arai Tatsuo Kanda Hitoshi Maruyama Jun Kato Naoya Kato |
| author_sort | Keisuke Koroki |
| collection | DOAJ |
| description | Background: There is no standard posttreatment for patients with advanced hepatocellular carcinoma (HCC) in whom lenvatinib therapy has failed. This study aimed to investigate rates of migration to posttreatment after lenvatinib and to explore candidates for second-line agents in the patients with failed lenvatinib therapy. Methods: We retrospectively collected data on patients with advanced HCC who received lenvatinib as the first-line agent in 7 institutions. Results: Overall survival and progression-free survival (PFS) of 178 patients who received lenvatinib as the first-line agent were 13.3 months (95% confidence interval [CI], 11.5–15.2) and 6.7 months (95% CI, 5.6–7.8), respectively. Sixty-nine of 151 patients (45.7%) who discontinued lenvatinib moved on to posttreatment. The migration rates from lenvatinib to the second-line agent and from the second-line agent to the third-line agent were 41.7 and 44.4%, respectively. Based on multivariate analysis, response to lenvatinib (complete or partial response according to modified RECIST) and discontinuation of lenvatinib due to radiological progression, as well as male were associated with a significantly higher probability of migration to posttreatment after lenvatinib. On the other hand, alpha-fetoprotein levels of 400 ng/mL or higher was correlated with a significantly lower probability of migration to posttreatment after lenvatinib. Of 63 patients who received second-line systemic therapy, 53 (84.2%) were administered sorafenib. PFS, objective response rate (ORR), and disease control rate (DCR) for sorafenib treatment were 1.8 months (95% CI, 0.6–3.0), 1.8%, and 20.8%, respectively. According to the Cox regression hazard model, Child-Pugh class B significantly contributed to shorter PFS. PFS, ORR, and DCR of 22 patients who received regorafenib after lenvatinib in any lines were 3.2 months (range, 1.5–4.9 months), 13.6%, and 36.3%, respectively. Similarly, PFS, ORR, and DCR of 17 patients who received regorafenib after lenvatinib in the third-line (after sorafenib) were 3.8 months (range, 1.1–6.5 months), 17.6%, and 41.2%, respectively. Conclusion: Sorafenib may not be a candidate for use as a posttreatment agent after lenvatinib, according to the results of the present study. Regorafenib has the potential to become an appropriate posttreatment agent after lenvatinib. |
| first_indexed | 2024-12-21T02:31:52Z |
| format | Article |
| id | doaj.art-4cc7f3182bb149d4bf42ff53cc56445b |
| institution | Directory Open Access Journal |
| issn | 2235-1795 1664-5553 |
| language | English |
| last_indexed | 2024-12-21T02:31:52Z |
| publishDate | 2021-04-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Liver Cancer |
| spelling | doaj.art-4cc7f3182bb149d4bf42ff53cc56445b2022-12-21T19:18:54ZengKarger PublishersLiver Cancer2235-17951664-55532021-04-0111210.1159/000515552515552Posttreatment after Lenvatinib in Patients with Advanced Hepatocellular CarcinomaKeisuke Koroki0Naoya Kanogawa1Susumu Maruta2Sadahisa Ogasawara3https://orcid.org/0000-0002-6540-9064Yotaro Iino4Masamichi Obu5Tomomi Okubo6Norio Itokawa7Takahiro Maeda8Masanori Inoue9Yuki Haga10Atsuyoshi Seki11Shinichiro Okabe12Yoshihiro Koma13Ryosaku Azemoto14Masanori Atsukawa15Ei Itobayashi16Kenji Ito17Nobuyuki Sugiura18Hideaki Mizumoto19Hidemi Unozawa20Terunao Iwanaga21Takafumi Sakuma22Naoto Fujita23Hiroaki Kanzaki24Kazufumi Kobayashi25Soichiro Kiyono26Masato Nakamura27Tomoko Saito28Takayuki Kondo29Eiichiro Suzuki30Yoshihiko Ooka31Shingo Nakamoto32Akinobu Tawada33Tetsuhiro Chiba34Makoto Arai35Tatsuo Kanda36https://orcid.org/0000-0002-3740-5090Hitoshi Maruyama37Jun Kato38Naoya Kato39Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Kimitsu Chuo Hospital, Kisarazu, JapanDepartment of Gastroenterology, Kimitsu Chuo Hospital, Kisarazu, JapanDivision of Gastroenterology, Department of Internal Medicine, Nippon Medical School Chiba Hokusoh Hospital, Inzai, JapanDivision of Gastroenterology, Department of Internal Medicine, Nippon Medical School Chiba Hokusoh Hospital, Inzai, JapanTranslational Research and Development Center, Chiba University Hospital, Chiba, JapanTranslational Research and Development Center, Chiba University Hospital, Chiba, JapanDepartment of Gastroenterology, National Hospital Organization Chiba Medical Center, Chiba, JapanDepartment of Gastroenterology, Funabashi Municipal Medical Center, Funabashi, JapanDepartment of Gastroenterology, Matsudo City General Hospital, Matsudo, JapanDepartment of Gastroenterology, Kimitsu Chuo Hospital, Kisarazu, JapanDepartment of Gastroenterology, Kimitsu Chuo Hospital, Kisarazu, JapanDivision of Gastroenterology, Department of Internal Medicine, Nippon Medical School Chiba Hokusoh Hospital, Inzai, JapanDepartment of Gastroenterology, Asahi General Hospital, Asahi, JapanDepartment of Gastroenterology, National Hospital Organization Chiba Medical Center, Chiba, JapanDepartment of Gastroenterology, National Hospital Organization Chiba Medical Center, Chiba, JapanDepartment of Gastroenterology, Funabashi Municipal Medical Center, Funabashi, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanDepartment of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, JapanBackground: There is no standard posttreatment for patients with advanced hepatocellular carcinoma (HCC) in whom lenvatinib therapy has failed. This study aimed to investigate rates of migration to posttreatment after lenvatinib and to explore candidates for second-line agents in the patients with failed lenvatinib therapy. Methods: We retrospectively collected data on patients with advanced HCC who received lenvatinib as the first-line agent in 7 institutions. Results: Overall survival and progression-free survival (PFS) of 178 patients who received lenvatinib as the first-line agent were 13.3 months (95% confidence interval [CI], 11.5–15.2) and 6.7 months (95% CI, 5.6–7.8), respectively. Sixty-nine of 151 patients (45.7%) who discontinued lenvatinib moved on to posttreatment. The migration rates from lenvatinib to the second-line agent and from the second-line agent to the third-line agent were 41.7 and 44.4%, respectively. Based on multivariate analysis, response to lenvatinib (complete or partial response according to modified RECIST) and discontinuation of lenvatinib due to radiological progression, as well as male were associated with a significantly higher probability of migration to posttreatment after lenvatinib. On the other hand, alpha-fetoprotein levels of 400 ng/mL or higher was correlated with a significantly lower probability of migration to posttreatment after lenvatinib. Of 63 patients who received second-line systemic therapy, 53 (84.2%) were administered sorafenib. PFS, objective response rate (ORR), and disease control rate (DCR) for sorafenib treatment were 1.8 months (95% CI, 0.6–3.0), 1.8%, and 20.8%, respectively. According to the Cox regression hazard model, Child-Pugh class B significantly contributed to shorter PFS. PFS, ORR, and DCR of 22 patients who received regorafenib after lenvatinib in any lines were 3.2 months (range, 1.5–4.9 months), 13.6%, and 36.3%, respectively. Similarly, PFS, ORR, and DCR of 17 patients who received regorafenib after lenvatinib in the third-line (after sorafenib) were 3.8 months (range, 1.1–6.5 months), 17.6%, and 41.2%, respectively. Conclusion: Sorafenib may not be a candidate for use as a posttreatment agent after lenvatinib, according to the results of the present study. Regorafenib has the potential to become an appropriate posttreatment agent after lenvatinib.https://www.karger.com/Article/FullText/515552hepatocellular carcinomalenvatinibposttreatment |
| spellingShingle | Keisuke Koroki Naoya Kanogawa Susumu Maruta Sadahisa Ogasawara Yotaro Iino Masamichi Obu Tomomi Okubo Norio Itokawa Takahiro Maeda Masanori Inoue Yuki Haga Atsuyoshi Seki Shinichiro Okabe Yoshihiro Koma Ryosaku Azemoto Masanori Atsukawa Ei Itobayashi Kenji Ito Nobuyuki Sugiura Hideaki Mizumoto Hidemi Unozawa Terunao Iwanaga Takafumi Sakuma Naoto Fujita Hiroaki Kanzaki Kazufumi Kobayashi Soichiro Kiyono Masato Nakamura Tomoko Saito Takayuki Kondo Eiichiro Suzuki Yoshihiko Ooka Shingo Nakamoto Akinobu Tawada Tetsuhiro Chiba Makoto Arai Tatsuo Kanda Hitoshi Maruyama Jun Kato Naoya Kato Posttreatment after Lenvatinib in Patients with Advanced Hepatocellular Carcinoma Liver Cancer hepatocellular carcinoma lenvatinib posttreatment |
| title | Posttreatment after Lenvatinib in Patients with Advanced Hepatocellular Carcinoma |
| title_full | Posttreatment after Lenvatinib in Patients with Advanced Hepatocellular Carcinoma |
| title_fullStr | Posttreatment after Lenvatinib in Patients with Advanced Hepatocellular Carcinoma |
| title_full_unstemmed | Posttreatment after Lenvatinib in Patients with Advanced Hepatocellular Carcinoma |
| title_short | Posttreatment after Lenvatinib in Patients with Advanced Hepatocellular Carcinoma |
| title_sort | posttreatment after lenvatinib in patients with advanced hepatocellular carcinoma |
| topic | hepatocellular carcinoma lenvatinib posttreatment |
| url | https://www.karger.com/Article/FullText/515552 |
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